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If you wish to emerge from your baby’s caesarean birth feeling positive then it is wise to take ownership over your baby’s birth. This means speaking up for what you want and do not want and placing yourself in the hands of people you trust and feel safe with.

Consider what your wishes would be for a caesarean birth when you are doing your birth preparation and planning. Then you will have the opportunity to communicate your most important desires for a caesarean birth with your place of birth and carers ahead of time. This doesn’t mean dwelling on the possibility of a caesarean, it just means considering and documenting what would make this type of birth as positive as possible for you, your partner and your baby.

Most of us like to avoid conflict. We are used to being told what we should or shouldn’t do by health professionals and we are in the habit of giving over our power and ownership to others in medical situations. Although it may be very challenging for you (it is for me!), your baby’s birth is an opportunity to begin advocating for yourself and for your unborn child. Through your experience of birth you can set the scene for future interactions with doctors, dentists, health nurses and teachers where you are a strong advocate and an expert in your needs and the needs of your children.

There are options for a caesarean birth that may not be offered to you as they are not standard care in most hospitals. Although a caesarean is surgery, it is also the birth of a baby, a mother and a father. Even in an emergency, this surgery can be performed with gentle and respectful intentions, with consciousness that this is a birth and it is a special day.

Based on many women’s stories and the work of retired US obstetrician, Robert Oliver, MD, board of directors of APPPAH, the Association for Pre and Perinatal Psychology and Health, these are my suggestions for turning a necessary caesarean into a positive and beautiful birth.

Not all of these are going to be possible for a mid-labour emergency caesarean or in every individual situation, but they are possible and achievable. Reading positive caesarean stories and asking questions of other women will help you to discover that the smallest things can make all the difference to your baby’s birth.

Robert Oliver MD writes about his experience with positive caesarean births: “It is our intention to maintain the mother’s control of the events. She must at all times feel she is important to and guiding the birthing, regardless of the emergency and the operative procedure.This also goes for the baby in a spiritual and metaphysical sense. Ideally the obstetrician and labor room personnel will honor these two people most strongly.”

Preparing for Caesarean Birth
It is OK to feel disappointed, sad, or angry before and after your baby’s birth. Seek an empathetic listener (eg, your doula or midwife) who will not dismiss your feelings, ‘jolly’ you along, or diagnose you with depression before you even have time to grieve the birth and meeting with your baby that you had hoped to experience.

If you feel ready and you have time to prepare for your caesarean birth, read positive caesarean birth stories so that you are familiar with what will happen and what the birth may feel like. These stories will also give you confidence to ask for what you want. Talking to other women will also help you to find out what products there are that may make your recovery easier. (There are three positive caesarean stories in the Birth Journeys book.)

Ask that your baby be placed on your chest before weighing, cleaning and paediatric assessment, unless absolutely necessary. Weighing and cleaning are not emergency procedures that have to happen the moment your baby is born – they can wait – but we tend to accept that they take place immediately after birth. There are many possibilities like this that are not widely discussed or offered.

Ask for delayed cord clamping so that your baby receives all the cord blood and oxygen from the placenta while they adapt to life outside the womb. A recent review of studies showed that delayed cord clamping provides longer term health benefits for your baby as well as supporting them as they begin to breathe. A lotus birth is possible with a caesarean birth and it ensures that your baby is not taken away (although baby may be held rather than placed on your chest) before the placenta is birthed.

Ask for the lights to be dimmed and the surgery to be a little warmer than usual for your baby’s birth. This is achievable and it will make your baby’s first moments in the world easier and the birth environment more pleasant for you too.

Ask for talking to be quiet and gentle with attention focused on you, your baby, your partner and this birth. One common complaint couples have after experiencing a caesarean birth is that medical staff carried on with their own conversations ignoring the presence and the feelings of the key people in this important event. Perhaps some surgeons and theatre staff have this habit because other ‘patients’ would not be listening in and they may not be aware of how it makes many couples feel.

Discuss your intentions for breastfeeding and how you will be supported after the caesarean birth. Identify how will you be helped to breastfeed, especially if there is a reason why you are unable to breastfeed your baby for the first few hours. Remember that skin to skin contact and allowing your baby to explore and find your nipple by themselves is a wonderful way to initiate breastfeeding and reconnect with your baby after a separation.

Caesarean births are sometimes linked to difficulties in establishing breastfeeding so consider finding the supportive friends and professionals now before your baby is born. It is easier to reach for support if you have already made contact before the birth.

You may wish to discover your baby’s sex for yourselves. You may like the doctors to welcome your baby by name. Ensure you make your wishes clear so that this special moment meets your wishes.

Use honey not vinegar to get what you want. If you are worried about dealing with potential conflict, try words like these: “It is important to us that… How can we work together to…” Eg, if you are concerned about your baby being taken away immediately after birth you could try words similar to “It is important to us that our baby is not separated from us. How can we do things so we have our baby in our arms straight after the birth?”

This may seem to be giving the power to find a solution to the doctors, but you are actually telling them what your concern is and what outcome you want. I’ve not had to use this method in maternity care, but I have used it in the operating theatre and recovery ward with my children to get what I knew they needed and it really works! Honest and respectful communication with the right person goes a long way.

On The Day
Have your partner place their hands on your belly or speak to your baby in the time before the caesarean birth begins. Your baby knows their daddy’s voice and this can help your partner to feel involved and connected with your baby and the birth.

Before the birth begins, ask to take a moment to welcome your baby and give thanks for their life and the wonderful care and the gentle hands of everyone in the room that will receive your baby into the world. If you would normally pray or say a few words before something momentous takes place then surely the caesarean birth of a baby fits this category. I believe your wish will be respected if you frame it as a need to give thanks, say a prayer or a blessing before your baby’s birth.

If saying something aloud is all too much, then ask for a everyone to share a moment’s silence to give thanks. Taking this small but very personal action will send a very clear message about the way you want this birth to be – respectful, gentle and calm. I have not read of this in any birth stories so you may be pioneers if you try this – be sure to let me know what happens!

Focus on your baby and visualise sending them reassurance and love. Let your baby know that it is safe for them to be born this way and that you are in control of what is happening. Talk or sing to your baby in your head or quietly – keep focused on them and their wellbeing and imagine them coming out into the light and the air. This will help you to feel involved and in control of the birth of your baby. By keeping calm, you support the wellbeing of both yourself and your baby. If this is not for you, use other methods such as counting backwards to help you keep calm.

Have a doula or familiar midwife in the theatre focused on your care and wellbeing. You’ll benefit from having someone there for you and your partner.

If you prepared for birth with hypnosis or meditation methods you may find these are still very useful during the birth. If you have prepared using breathing techniques or counting methods these amy also be helpful for you. (See the links below for hypnobirthing specifically for caesarean birth.)

If you are unable to hold your baby post-birth, your partner can hold your baby against his bare chest with a blanket over them both, or even inside his shirt. Your baby will be kept warm and will love this close contact with daddy.

Remember it is your birth and your baby’s birth not just an operation. Every aspect of this birth may be performed with an intention to help, to care and to show respect for you, your baby and your partner. You deserve this.

Birth Journeys is not a collection of ‘perfect’ birth stories. The stories in this book have been carefully selected to reflect different women, their unique journeys and their experiences of positive birth. The stories are diverse and they have been chosen to speak to different readers. Not every story will appeal to you – there may be some that you do not wish to read.

The stories in this book include: births in hospitals, birth centres and at home; vaginal births after caesarean (VBAC); a twin birth; and emergency and elective caesareans. There are: first births, second births and even fifth births; water births; and an unassisted birth. There are stories that give an insight into the experience of pregnancy and birth from a man’s perspective. The stories also show that there are many different experiences of labour: a strenuous challenge; a strong, determined fight; calm and deeply focused; a wild instinctive ride or a joyful and ecstatic trance.

In Birth Journeys, you will meet women who felt nurtured by carers, partners, family and friends during pregnancy and birth. They were celebrated and honoured. These women share the excitement and joy they felt as they anticipated their baby’s birth.

Some women carefully chose their place of birth based on their need to feel safe, private and comfortable. These women describe how important it was for them to find a carer who shared their values and beliefs about birth. Some deliberated over their choice, and others felt an immediate connection and just knew they had the right carer. Other women demonstrated open and respectful communication with carers.

There are women who spent considerable time reading and researching to educate themselves about labour and birth. They reflected on their beliefs and their past experiences. They filled their minds with affirmations and visualisations to become confident in their ability to have a positive birth.

Some women share a disappointing or traumatic first birth followed by a healing later birth. Many came from a place of fear, while a few entered pregnancy with feelings of ease and confidence. They had not been exposed to the culture of fear or a family history of birth ‘gone wrong’. For them, birth was a normal part of life.

There are women who stood firmly by their beliefs, intuition and wisdom in the face of challenges, and others who learnt the value of being flexible and willing to change. These women were graceful as their dream birth slipped away.

The stories are honest and real. They reveal the unique, deeply personal experiences of ‘everyday’ people. These women (and men) have generously shared their choices, feelings, beliefs and learnings. They have entrusted us with their precious memories.

(this is an excerpt from the Introduction to Birth Journeys)

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